Dyssomnia
covers a range of specific sleep disorders, the Inability to Sleep,
Insomnia, Sleeplessness, Wakefulness. Chronic and persistent difficulty
in either; falling asleep, remaining asleep through the night,
or waking up too early. All types of insomnia can lead to daytime
drowsiness, poor concentration, and the inability to feel refreshed
and rested in the morning.
The Dyssomnias
are disorders of sleep or wakefulness they are not Parasomnias.
Dysosomias therefore include the following specific disorders:
Insomnia.
Apnea
Insomnia may
be divided into three groups: transient insomnias, which last
for several days; short-term insomnias, which can last up to three
weeks; and chronic insomnias, which continue for more than three
weeks.
Associated
Features:
Psycho-Physiologic
Insomnia.
Idiopathic.
Narcolepsy.
Recurrent Hypersomnia.
Obstructive Apnea Syndrome.
Mixed Apnea Syndrome.
Central Apnea Syndrome.
Alveolar Hypoventilation.
Periodic Leg Movements and Leg-Related Syndrome.
Differential
Diagnosis:
Some disorders have similar symptoms. The clinician, therefore,
in his diagnostic attempt has to differentiate against the following
disorders which need to be ruled out to establish a precise diagnosis.
Nightmare
Disorder
Depression
Cause:
For many people,
poor sleep habits are the cause. However, because insomnia is
a key symptom of depression,
you should be evaluated for depression if you are having sleeping
difficulties. Generally transient insomnias may be caused by stress,
changes in sleeping patterns, related to shift working and jet
lag. Short-term insomnias may be caused by the effects of severe
stressful events, serious family or relationship problems and
bereavement.
Finally the causes of chronic insomnia are more evasive and difficult
to identify. Some factors associated with Dyssomnia are therefore:
Jet Lag
Shift Work
Grief
Depression or Major Depression
Anxiety or Stress
Nicotine, Alcohol, Caffeine or other stimulants at bedtime
Natural Aging Process
Excessive Daytime Sleeping
Overactive thyroid (hyperthyroidism)
Medication side-effects
Abruptly Stopping a Medication (such as sleeping pills).
Treatment:
Drug treatment should only
be resorted to a as a last option. Practice good sleep
hygiene: avoid using alcohol in the evening and to avoid caffeine
before bedtime.
Establish
a regular bedtime, but don't go to bed if you feel wide awake.
Use the bedroom for bedroom activities only. Once in bed, use
creative imagery and relaxation techniques to keep your mind off
unrestful thoughts. Avoid staying in bed for long periods of time
while awake, or going to bed because of boredom. Relax by reading,
taking a bath, or listening to soothing music before getting to
bed.
Counseling
and Psychotherapy [ See
Therapy Section ]:
Counseling
may be helpful for psychological disorders that lead to insomnia
and the practice of relaxation techniques may also be helpful.
Pharmacotherapy
[ See Psychopharmacology
Section ] :
Antidepressants
can often help both the sleeping problem and the depression
usually associated with the disorder. As previously indicated
medication should be a last resort only.
